Background:Lung cancer is responsible of 12.4% and 17.6% of all newly diagnosed cancer cases and mortality due to cancer, respectively, and 5-year survival rate despite all improved treatment options is 15%. This survival rate reaches 66% in the Stage 1 and surgically treated patients. Early diagnosis which could not be definitely and commonly achieved yet is extremely critical in obtaining high survival rate in this disease. For this reason; proteomic differences were evaluated using matrix assisted laser desorption ionization (MALDI) mass spectrometry in the subgroups of lung adenocarcinoma and squamous cell carcinoma.Methods:Fresh tissue samples of 36 malignant cases involving 83.3% (n = 30) men and 16.7% (n = 6) women patients were distributed into 2 groups as early and end stage lung cancer and each group were composed of subgroups including 18 squamous cell carcinoma (9 early stage cases, 9 end stage cases) and 18 adenocarcinoma cases (9 early stage cases, 9 end stage cases). The fresh tissues obtained from the tumoral and matched normal sites after surgical intervention. The differences in protein expression levels were determined by comparing proteomic changes in each patient.Results:In the subgroups of advanced stage adenocarcinoma; tumoral tissue revealed differences in expression of 2 proteins compared with normal parenchymal tissue. Of those; difference in protein expression in heat shock protein 60 (HSP60) was found statistically significant (P = 0.0001). Subgroups of early and advanced stage squamos cell carcinoma have differed in certain 20 protein expression of normal tissue and diseased squamos cell carcinoma. Of those, increased protein expression level of only annexin-2 protein was found statistically significant (P = 0.002). No significant difference was detected in early and advanced stage protein expressions of the tumoral tissues in the subgroups of adenocarcinoma and squamous cell carcinoma.Conclusions:We conclude that with respect to early diagnosis of lung cancer that HSP60 and annexin-2 proteins are the important biomarkers in the subgroups of adenocarcinoma and squamous cell carcinoma. We also consider that these 2 proteins are molecules which may provide critical contribution in evaluation of prognosis, metastatic potential, response to treatment, and in establishment of differential diagnosis between adenocarcinoma and squamous cell carcinoma.
The exercise capacity of patients with advanced-stage NSCLC is lower due to reduced pulmonary functions and peripheral muscle strength compared to patients with early-stage NSCLC. Therefore, we can conclude that reduced exercise capacity negatively impacts functional categories of health related quality of life of patients with advanced-stage NSCLC.
Bu çalışmada yelken göğüs hastalarında konservatif ve cerrahi stabilizasyon yaklaşımlarının klinik sonuçları karşılaştırıldı ve erken redüksiyonun etkisi araştırıldı. Ça lış m a pla nı: Mart 2013-Aralık 2017 tarihleri arasında erken kaburga fiksasyonu yapılan yelken göğüslü 34 hasta (23 erkek, 11 kadın; ort. yaş 43.7±12.1 yıl; dağılım 20-74 yıl) cerrahi grubuna ve Şubat 2012-Aralık 2017 tarihleri arasında konservatif yaklaşım ile takip edilen yelken göğüslü 29 hasta (19 erkek, 10 kadın; ort. yaş 45.7±15.8 yıl; dağılım 24-74 yıl) konservatif tedavi grubuna alındı. Travmanın olduğu gün veya bir sonraki gün (24 ila 36 saat içerisinde) erken kaburga redüksiyonu uygulandı. Hastanede kalış süresi, ameliyat sonrası dönemde pnömoni ve septik komplikasyon varlığı, mortalite, mekanik ventilasyon süresi, trakeostomi oranı, solunum fonksiyon test sonuçları ve ağrı skorları kaydedildi ve gruplar arasında karşılaştırıldı. Bul gu lar: Hastanede ve yoğun bakım ünitesinde yatış süresi ve mekanik ventilasyon süresi cerrahi grubuna kıyasla, konservatif tedavi grubunda istatistiksel olarak anlamlı düzeyde daha uzun idi (sırasıyla p<0.001, p<0.001 ve p<0.001). Cerrahi grupta hiçbir hastada trakeostomi gerekmez iken, konservatif tedavi grubunda beş hastada trakeostomi gereksinimi oldu (p= 0.004). Mortalite oranları cerrahi ve konservatif tedavi gruplarında sırasıyla %2.94 ve %20.69 idi (p= 0.027). Ağrı skorları, konservatif tedavi grubuna kıyasla, cerrahi grup lehine istatistiksel olarak anlamlı düzeyde farklı idi (sırasıyla p= 0.0038 ve p= 0.044). So nuç:Çalışmamızın sonuçları erken fiksasyon ve erken ekstübasyonun mekanik ventilasyon gereksinimini, hastanede yatış süresini, trakeostomi ihtiyacını ve ölüm oranlarını azalttığını göstermektedir. Bu yaklaşım, yelken göğüs hastalarında uzun dönem ağrı şikayetinde ve solunum fonksiyon testlerinde önemli bir iyileşme sağlar. Anah tarsöz cük ler: Yelken göğüs, kilitli kaburga plağı, kaburga kırığı, toraks travması.
Bu çalışmada kaburga kemiği uzunluğunun kostal kıkırdak uzunluğuna oranının göğüs duvarı deformitesi şiddetinin belirlenmesinde etkili olup olmadığı araştırıldı. Ça lış mapla nı:Çalışmaya göğüs duvarı deformitesi nedeniyle ameliyat edilen 72 hasta (64 erkek, 8 kadın; ort. yaş 18.5±6 yıl; dağılım, 6-40 yıl) ve 38 kontrol deneği (22 erkek, 16 kadın; ort. yaş 14.6±4.2 yıl; dağılım, 6-25 yıl) dahil edildi. Hastaların 69'unda pektus ekskavatum ve üçünde pektus karinatum saptandı. Tüm katılımcıların kaburga kemiği uzunluğu-kostal kıkırdak uzunluğu oranı indeksi, Haller indeksi, düzeltme indeksi ve bilgisayarlı tomografi depresyon indeksi ölçüldü ve karşılaştırıldı. Bul gu lar: Hasta grubunda bilgisayarlı tomografi depresyon indeksi ve kaburga kemiği uzunluğu-kostal kıkırdak uzunluğu oranı indeksi arasında hafif düzeyde anlamlı negatif bir ilişki vardı (p<0.05). Bilgisayarlı tomografi depresyon indeksi dışında, hasta grubunda kaburga kemiği uzunluğu-kostal kıkırdak uzunluğu oranı indeksi ve diğer indeksler ve kontrol grubu indeksleri arasında anlamlı bir ilişki yoktu. Kontrol grubuna kıyasla hasta grubunda kaburga kemiği uzunluğu kostal kıkırdak uzunluğundan daha yüksekti. Hasta ve kontrol grupları arasında kostal kıkırdak uzunluğu açısından istatistiksel olarak anlamlı farklılık yoktu (p>0.05). So nuç: Beklenenin aksine, hasta ve kontrol grupları arasında kostal kıkırdak uzunluğu açısından anlamlı farklılık yoktu. Dolayısıyla, göğüs duvarı deformitelerinin şiddetinin belirlenmesinde kostal kıkırdak uzunluğunun etkili olup olmadığını ortaya koymak için daha geniş serili çalışmalar gereklidir. Anah tarsöz cük ler:Göğüs duvarı deformiteleri; Haller indeksi; kostal indeksler.
Purpose: We performed an experimental study comparing different suture techniques in trachea anastomoses using the ex vivo sheep model, which deals with the parameters that suture tension, air leakage, intraluminal pressure, and tension at which the anastomosis will rupture. We aimed to find an answer to “Which suture technique should be used in tracheal anastomoses?”Methods: In all, 45 sheep tracheas were randomly divided into three groups (each n = 15) differing in suture technique for anastomoses: single stitches, mixed, and continuous suture. The anastomoses were evaluated for air leakage under normal (25 mbar) and high (70 mbar) intraluminal pressures without tension. Then, air leakage was followed under high intraluminal pressure with tensile stress. Tension levels of dehiscence were also recorded. Data were statistically evaluated.Results: No air leakage was observed at 25 mbar intraluminal pressure. At 70 mbar pressure without tension, no statistically significant difference was found among the groups (p >0.05). However, single-stitch technique was the best in terms of air leakage tension and rupture tension levels (p <0.05).Conclusion: The most reliable and advantageous is single-stitch technique for a tracheal anastomosis in short-term results. Further studies are needed to analyze longer ventilation periods in terms of other serious complications as ischemic dehiscence and stenosis.
Using of atrial septal defect occluder device may be an appropriate option for tracheoesophageal fistula treatment. It can be said that the procedure is successful when the device is completely covered. Even so, there is a need for multi-centered, randomized, controlled studies of large series about the subject.
Aim: Tube thoracostomy is an interventional procedure in which there is a high risk for the spread of COVID-19. In this study, we compare the tube thoracostomy procedures performed early on in the pandemic and those performed later after steps were taken in accordance with the new recommendations. Material and Method:It is a retrospective and single-center study. COVID-19 patients with spontaneous pneumothorax with indications for tube thoracostomy presented to our emergency department between March 10, 2020, and March 31, 2021. Based on the applied tube techniques, two groups were defined; group 1, patients who underwent classical tube thoracostomy, group 2, patients who underwent tube thoracostomy with the recommended preventive measures for COVID-19. The collected data were compared between the two groups.Results: 106 patients met the study criteria and were included in the study. The difference in the length of the tube duration time between the old or new technique was statistically significant (p < 0.05), no difference was identified in the duration of stay, intensive care unit admission, or mortality compared with the two techniques. Conclusions:In this study, the new measures recommended for tube thoracostomy were found to be effective for the treatment of patients.
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